Considerations

This nulliparous woman has lower abdominal pain, adnexal tenderness, and cervical motional tenderness. The presence of cervical motion tenderness is indirect, based on the dyspareunia and hyperemic cervix. The patient also has fever. These are the clinical criteria for PID or salpingitis (infection of the fallopian tubes). Salpingitis is most commonly caused by pathogenic bacteria of the endo-cervix that ascend to the tubes. The fallopian tubes can become damaged by the infection, leading to tubal occlusion and infertility or ectopic pregnancy.

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